Public irritated by yet another condom shortage

At the Kampala headquarters of an NGO that looks after sex workers, staff members make calls to the government, the UN Population Fund (UNFPA) and various NGOs in search of much-needed free condoms.

"The clinic where we normally get them has none and UNFPA says they can only give them to the government, so we are stuck," said Macklean Kyomya, founder of the Women's Organization Networking for Human Rights Advocacy. "Our members [sex workers] up-country need condoms or they are at risk of sexually transmitted infections and HIV."

Several districts have run out of condoms after the National Medical Stores’ (NMS) stocks were revised downwards. In the past, the NMS had a minimum stock level of six months and a maximum of 12 months, but this has since been changed to a maximum stock level of six months' worth of condoms due to the large amount of storage space required.

"The procurement process is very long and the delivery is not at regular intervals so sometimes we under-estimate their arrival," said Vastha Kibirige, head of the condom monitoring unit in the Ministry of Health. "We need a condoms- or contraceptives-only warehousing facility and a contracted exclusive distributor for these commodities."

Ugandans use between eight and 10 million condoms every month, but the government estimates that to cover all risky sex acts, the country needs at least 208 million condoms per year.

The shortage is not expected to last longer than a month – the Global Fund to fight AIDS, tuberculosis and malaria and the US and UK governments are donating 96 million, 15 million and five million condoms respectively, while the NMS is expecting a consignment of 45 million by the end of the year.

Nevertheless, Ugandans are irritated by the government's failure to maintain a regular supply of condoms.

"This is not the first time we have had such a shortage – why is it so hard to be organized? These are things that can save lives," said Jessica Kyembabazi, a hairdresser in Kampala.

Following the recall of the foul-smelling Engabu brand of government-issued condoms in 2004, the country experienced a nationwide condom shortage.

"Many people can't afford the expensive condoms in pharmacies – what are they supposed to do?" Kyembabazi asked. "Why do they [the government] tell us to use condoms and then fail to make them available? It defeats their own HIV campaign."

In the private sector, condoms cost between US$0.25 and $2 for three. "We have not increased the price and hopefully we shall not," said Paul Lukwago, who works at a local pharmacy, adding that so far, he had not noticed an increase in demand for condoms at his pharmacy.

Ministry of Health officials are advising Ugandans to choose one of the other HIV prevention methods - abstinence or faithfulness to one sexual partner - until condoms become more available.

Kibirige suggested that in the meantime, people could also use the oft-neglected female condom. "Uptake of female condoms is good, with less complaints and demand is well below what we have in stock," she said.

A 2009 study of a new brand of female condom found high levels of acceptability among women in four Ugandan districts.